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UN Special Envoy for HIV/AIDS in Africa: “The World is Facing an Apocalypse and the Int’l Community Response is Abysmal”

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Today is World AIDS Day, an annual campaign dedicated to reaffirming the commitment to fight HIV/AIDS and to remembering the 20 million people who have died from the disease. We speak with Stephen Lewis, the United Nations Special Envoy for HIV/AIDS in Africa. [includes rush transcript]

Today is World AIDS Day. Across the world, activists and governments are due to mark World AIDS day with events drawing attention to the disease and promoting its eradication. More than 20 million have died since the onset of the AIDS pandemic two decades ago. Less than 5 percent of those suffering from the disease are receiving treatment and no vaccine or cure is in sight.

This year’s focus is on the number of women who contract the HIV/AIDS. A new report has found the virus infection is now growing more rapidly in women than in men throughout most of the world. In Sub-Sahara Africa, women now make up 57 percent of the people living with HIV.

To mark World AIDS Day here in the U.S., activists across the country will hold demonstrations to protest the Bush administration’s attacks on HIV prevention programs as well as funding cuts to the UN-backed Global Fund to Fight AIDS. This is Asia Russell a member of the AIDS advocacy group Health GAP speaking outside the home of Pennsylvania Sen. Arlen Specter.

  • Asia Russell, member of the AIDS advocacy group Health GAP speaking outside the home of Sen. Arlen Specter (R-PA), November 30, 2004.
  • Stephen Lewis, the United Nations Special Envoy for HIV/AIDS in Africa. He is the former Canadian Ambassador to the U.N. and a former Unicef official. In May 2003 he founded the Stephen Lewis Foundation to help women dying of AIDS in Africa and the orphans they leave behind.

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This is a rush transcript. Copy may not be in its final form.

AMY GOODMAN: Yesterday, Asia Russell, a member of the AIDS advocacy group Health GAP was part of a small protest outside the home of Pennsylvania Republican senator Arlen Specter.

ASIA RUSSELL: I just came back from the Global Fund’s ninth board meeting in Arusha, Tanzania and it was at this board meeting the US administration — the Bush administration — tried its hardest to shut the Global Fund’s doors. It tried to prevent the launch of a fifth round of grants, and at the same time it was cracking down on this important institution in Arusha, Senator Specter and his cronies in the U.S. Congress were cutting new spending for the Global Fund by 36%. The Global Fund is desperately under-funded. Arlen Specter claims to be a leader for people living with HIV, but he is actually doing the opposite, under direct orders from the Bush administration. … The Global Fund goes against what this administration’s global AIDS policies are. It’s everything the Bush administration is not. It is multilateral. It funds interventions based on science, not ideology. It supports comprehensive sex education. It supports the procurement of generic medicines. It supports country-led responses to the AIDS pandemic. Meanwhile, back at home, the Bush administration is using its bilateral PEPFAR initiative as a way to try to force countries to accept brand name overpriced pharmaceutical medicines, and embrace interventions that just don’t work. Quack prevention like abstinence only until marriage programs that are actually going to put Africans at risk of HIV at greater risk of infection rather than preventing the transmission of the disease. … I think now that we have another four years of this administration it has become clear that we have to increase our power and our strength and our criticism of these powerful men like Arlen Specter, like Bill Frist, like Mitch McConnell who are working in lock step with the administration and are exploiting this agenda of compassion in order to undermine this global struggle to win treatment access for people living with HIV. Now is the most crucial time, 8200 people are dying every single day. The Global Fund is teetering on the brink of shutting its doors and the Bush administration has to be held to account for the impact of its policies.

AMY GOODMAN: That’s Asia Russell, a member of the AIDS advocacy group Health GAP. President Bush and his state of the union address had this to say about AIDS.

GEORGE BUSH (tape): AIDS can be prevented. Antiretroviral drugs can extend life for many years and the cost of those drugs has dropped from $12,000 a year to under $300 a year, which places a tremendous possibility within our grasp. Ladies and gentlemen, seldom has history offered a greater opportunity do so much for so many. We have confronted and will continue to confront HIV/AIDS in our own country and to meet a severe and urgent crisis abroad, tonight I propose the Emergency Plan for AIDS Relief, a work of mercy beyond all current international efforts to help the people of Africa. This comprehensive plan will prevent seven million new AIDS infections, treat at least two million people with life-extending drugs, and provide humane care for millions of people suffering from AIDS and for children orphaned by AIDS. (applause) I ask the Congress to commit $15 billion dollars over the next five years including nearly $10 billion dollars in new money to turn the tide against AIDS in most afflicted nations of Africa and the Caribbean.

AMY GOODMAN: President Bush in his state of the union address. We are joined by Stephen Lewis, the United Nations special envoy for HIV/AIDS in Africa, former Canadian ambassador to the United Nations and former UNICEF official. Last year he founded the Stephen Lewis Foundation to help women dying of AIDS in Africa and orphans they leave behind. Welcome to Democracy Now! Your response to President Bush?

STEPHEN LEWIS: I smiled to myself gently at the opening where he indicated the cost of drugs had come down to under $300 per person per year. I imagine if you did some investigative journalism you would find that speechwriter had quietly retired to other climes because of course, it is only generic drug prices that have come down to under $300 per year. The brand name drugs are a minimum twice that and more. And obviously in the president’s major plan the money which is used for the purchase of drugs is used for the purchase of brand name pharmaceuticals, not generics. That’s one of the divides between the President’s plan on one hand, and the way the Global Fund on AIDS, Tuberculosis and Malaria, and the World Bank, and UNICEF, and the Clinton Foundation, everybody else is emphasizing generics because they are so much less expensive and therefore you treat greater numbers of people. On the other hand, and I want to say this Amy because it is important, when you inject over a period of time $15 billion in the struggle against the pandemic, even if people like myself and others think that there are numbers of conditions which we would prefer not be there, you have got to do some good. You can’t escape doing some good. And I wish we could resolve this adversarial conflict between the Bush plan and everybody else because it is complicating what is happening on the ground and people are dying in hallucinatory numbers.

AMY GOODMAN: Talk about the global picture.

STEPHEN LEWIS: Well, the global picture is very depressing. The report of November 23, just a week or so ago, the update until the end of 2004 indicated that it is women in particular who are vulnerable and they are. They are incredibly disproportionately vulnerable. They are more vulnerable physiologically and they are more vulnerable because of gender inequality, because of cultural inequality. You indicated, when you were reading earlier, that 57% of all of the infections in Africa now are amongst women. Amy, in the age group 15 to 24, where there are over six million people infected, 75% are young women and girls. I mean it is appalling what is happening. We are depopulating parts of the continent of its women where we’re using language like women are an endangered species in certain countries and it’s objectively true. And the inability of women to refuse sexual overtures, to say to a man wear a condom, to negotiate safe sex, the destructive power relations around sexuality in areas of gender inequality are dooming women in huge numbers and there is no infrastructure, legal construct, which says women have property rights, inheritance rights there are tough laws against sexual violence and rape because when societies are falling apart there’s a lot of sexual violence and that spreads the virus as well. The virus spread in significant measure by predatory male sexual behavior, and we are trying around the world to shore up those women’s rights activists who are trying to empower women and inch our way toward gender equality. That’s the only way to break the back of the pandemic because the women carry the burden of care, they do all the work and they are being ferociously assaulted by the virus.

AMY GOODMAN: And what happens to the children?

STEPHEN LEWIS: The children then are orphaned when their mother’s die. Amy, I can’t tell you how many women come up to me on a regular basis as I travel through the African countries and very poignantly it’s terribly distressing, they say to me, with their children in tow, Mr. Lewis, what is going to happen to my children when I die? They’re all in their 20’s. It is just so distressing. And the kids, there are now 14 million orphans in sub-Saharan Africa. It’s expected to rise to over 20 million by 2010. These kids are vulnerable, frantic, bewildered, abandoned, desperately yearning for love and nurture. The communities try to absorb them but the communities are desperately poor. You take in a few more mouths and you push the surrogate family or the foster parents over the line. So, increasingly what is happening is that grandmothers are looking after the orphaned kids. I mean you have this violation of all the rhythms of life. The grandmothers bury their own adult children then they look after their orphaned grandchildren. In the country of Botswana which has the highest prevalence rate for many years, 50% of the children orphans are being looked after by grandmothers. Grandmothers are the heroes of the continent. But they are in their 60, 70’s, and 80’s. When they die there’s no one coming up behind. So you have this almost bizarre phenomenon of child-headed households, of the oldest child looking after the siblings in the family. And there are many child-headed households headed by children who are eight, nine and ten years old.

AMY GOODMAN: We are talking to Stephen Lewis, United Nations special envoy for HIV/AIDS in Africa. What about the policies of the pharmaceutical companies? What specifically can be done?

STEPHEN LEWIS: You know, there’s been a fascinating shift there because in truth the major brand name pharmaceutical companies are no longer key to the equation as they once used to be. We have moved dramatically toward the use of generic drugs which are purchased from Indian pharmaceutical companies, two in particular — one called Sipla, one called Ranbaxy. Thanks to the Clinton Foundation initiative, the price that has now been negotiated — this is quite incredible — is under $150 per person per year. So, if the western world delivered on the financial promises it perpetually makes and then refuses to acknowledge, we would be able to provide free treatment for everyone who needed it. And there is a target now. The World Health Organization wants to put three million people into treatment by the end of the year 2005. They call it the three by five initiative. It is visionary and important.

AMY GOODMAN: President Bush’s $15 billion plan prioritizes abstinence-based AIDS prevention. Only a small percentage of the money will go to the multilateral Global Fund to Fight AIDS. The U.S. supports the so-called ABC prevention technique, which stands for “abstain, be faithful or use a condom.” Critics say condoms shouldn’t be a last resort because women around the world often don’t have the option of abstinence.

STEPHEN LEWIS: Women in marriage certainly don’t have the option. In marriage abstinence neither desirable nor possible. Being faithful is an assumption you make, and wearing a condom can’t be imposed on a man who so often is many years older than the young woman who has been married, because early marriage is product of gender inequality. So the ABC formula is clearly not applicable to married situations in many instances. Amy, one of the astonishing things which has emerged in the last couple of years through studies is that one of the highest risk environments for women in Africa is to be married. The levels of prevalence among sexually active young women outside of marriage are lower than the prevalence rates of HIV within marriage. So, a whole new approach has to be made to the matter of prevention and how you enhance this ABC formula. The Bush administration’s emphasis on abstinence and it’s in the preventive part of the Bush money, does worry a lot of people because, while it has some application obviously, it doesn’t have exclusive or total application, and to overemphasize it at the expense of condoms or other intervention seems foolhardy. In addition to that, the amount of money which is going to the Global Fund from the United States, and the Global Fund is really the best multilateral financial agency that has emerged in years, and yet the American contribution at the moment is somewhere between $200 million a year, which is the Bush administration’s request, Congress bumps it up, this year they bumped it up to $350 million, that is very much less than it was last year. Everybody hoped that of the $3 billion a year, the administration would allow $1 billion to go to the Global Fund. It’s terrible setback for the Global Fund that the United States has decided to diminish the contribution.

AMY GOODMAN: What bearing does the Christian Right have on the Bush administration’s policies?

STEPHEN LEWIS: Well, the assumption, I think is — I’m going to be cautious when I reply because I don’t want to self-immolate on Pacifica Radio and television. But I think generally the feeling is that the Christian Right has influenced the abstinence policy very, very strongly and there is some apprehension about that. And ideologically there is obviously a resistance to multilateralism. Obviously the United Nations is not in great favor. Obviously, organizations that work in many countries … the Bush plan — we haven’t said this yet, but it’s worth saying — is confined to 15 countries, only 12 of which are in Africa. Which means some very high prevalence countries desperately in need of money are not included — Swaziland, Lisutu, Malawi — they’re not included. The Global Fund is dealing in over 120 countries, Amy. It’s much, much more widespread.

AMY GOODMAN: Before you go, just very quickly, as a former Canadian ambassador to the United States —

STEPHEN LEWIS: United Nations.

AMY GOODMAN: To the United Nations. Several thousand Canadians marched through the streets of Ottawa yesterday as President Bush made his first state visit. They carried signs like “End the massacre in Iraq” and “Some terrorists wear suits.” Your response to the U.S. in Iraq and U.S.-Canadian relations.

STEPHEN LEWIS: Well, I’m a social democrat. I always have been. That doesn’t disappear because I’m doing a different job. And I recognize that in Canada there was very significant resistance to the war in Iraq, which remains true to today. That’s why Canada didn’t join and that’s why these demonstrations are so heart felt and are being pursued. They do reflect a significant proportion of Canadian society.

AMY GOODMAN: And your thoughts.

STEPHEN LEWIS: My own thoughts? I have tremendous anxiety about what is happening in Iraq. I think that the aftermath is proving to be dreadful for everyone on every front. And I wish there were a way of resolving it. But it strikes me that that’s going to be a long way down the road.

AMY GOODMAN: Stephen Lewis, I want to thank you for being with us. Stephen Lewis is the U.N. HIV/AIDS ambassador to Africa and also has founded the Stephen Lewis Foundation, which deals with women dying of AIDS in Africa and the orphans they leave behind.

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